Anemia in physiology
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Transcript of Anemia in physiology
Anemia
Physiology Project
Kazan State Medical University
By:Mahi
ANAEMIADefinition:
Anemia is defined as a decreased O2 carrying capacity due to quantitative and qualitative Reduction in RBC counts and Hemoglobin levels.
By:Mahi
ANAEMIA ANAEMIA is labelled
when Hb is less than 13gm/dl in Males 11 gm/dl in Females 15gm/dl in Newborn.
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By:Mahi
MORPHOLOGICAL CLASSIFICATION:
normochromic
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Etiological Classification
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DUE TO DECREASED RBC PRODUCTION.
IRON DEFICIENCY ANAEMIA.
In women of reproductive age group (20-45 yrs)
In periods of active growth of infancy, childhood & adolescence
By:Mahi
IRON METABOLISM Total body contains 4-5 gms Forms –
Haemoglobin 70% Storage iron 20-23% 2/3rd
Ferritin & 1/3rd Haemosiderin.
Myoglobin in red muscles 5% Intracellular enzymes 2-3%
By:Mahi
DAILY REQUIREMENTS & SOURCES
5-10 mg/day in Males 20 mg/day in
Females. 40 mg/day in
Pregnant & lactating women.
Meat, liver, egg, green leafy veg, Jaggery & whole wheat.
By:Mahi
By:Mahi
IRON ABSORPTION
Mainly in duodenum & upper jejunum.
MECHANISM Transport across brush
borders Haeme iron Non-haeme iron.
Fate in Enterocytes. Transport in plasma.
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IRON ABSORPTION Transport across brush
borders. Absorption of Haeme
form Absorption of Non-
haeme form Fate in Enterocytes. Transport in plasma.
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Factors affecting iron absorption
Form of dietary iron – haem iron Non-haem iron – ferrous form (Fe2+) > ferric form
(Fe3+) Meat & fish ,Human breast milk ,Acid gastric
juice – enhances absorption. Dietary factors – Phytates , phosphates, calcium,
egg white, phenols, tea, coffe wine reduces. Iron stores in body – Negative feedback effect.
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STORAGE OF IRON As ferritin As haemosiderin.
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REGULATION OF BODY IRON Mucosal block theory of absorption. Saturation of apoferritin & apotransferrin Decresed rate of apoferritin synthesis. Role of specific iron receptors in brush borders.
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By:Mahi
By:Mahi
APPLIED ASPECTS. Iron deficiency- iron
deficiency Anaemia Iron excess –
Haemosiderin accumulation – Haemosiderosis – damages tissue – Haemochromatosis.
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CAUSES OF IRON DEFICIENCY ANAEMIA.
Inadequate dietary intake.
Increased loss of iron. Increased demand of
iron. Decreased absorption.
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Megaloblastic Anaemia Megaloblast –
abnormally large cells of Erythroid series.
Caused by defective DNA synthesis due to deficiency of Vit B12 & Folic acid.
By:Mahi
Vit B 12 (Extrinsic Factor) Vit B12 –
Cyanocobalamin or extrinsic factor.
Daily need – 1-2 μg. Sources – Milk, Meat,
Liver of Animals Also synthesized by
bacterial Flora.
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Vit B 12 (Extrinsic Factor) Absorption – need
Intrinsic Factor Of Castle , a glycoprotein secreted by parietal cells of gastric mucosa.
With it form Intrinsic Factor- Cyanocobalamin complex
Bound to sp receptors in ileum & absorbed by Endocytosis.
By:Mahi
Vit B 12 (Extrinsic Factor) Transport – in blood
transported by combining with Transcobalamin-II
Storage – In liver & Muscle
Role – required for synthesis of DNA & maturation of nucleus & cell.
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Folic Acid Folic acid –
Pteroylglutamic acid. Daily requirement –
100 μg. Sources – leafy veg,
pulses, yeasts, liver. From breakdown of
Polyglutamate to Monoglutamates.
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Aetiology. Due to vit B12
deficiency Causes –
Inadequate dietary intake
Malabsorption due to gastric cause
Intestinal Cause.
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Addisonian Pernicious Anaemia.
Aetiology – vit B12 deficiency due to failure of secretion of Intrinsic Factor by stomach due to Autoimmune Atrophy of Gastric Mucosa.
Features. Features of
Megaloblastic anaemia Anti-intrinsic factor
antibodies. Schilling test.
(abnormal vit B12 absorption test corrected by addition of Intrinsic Factor)
By:Mahi
Clinical Features: General features of Anemia
Pallor, Weakness, Lethargy,
Breathlessness on exertion
Palpitations heart failure pedal edema
Special features :
Angular cheilitis, Atrophic glossitis,
Oesophageal atrophy/web Dysphagia,
Koilonychia, brittle nails, gastric atrophy.
By:Mahi
Special features :
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LAB FINDINGS Blood picture & red cell
indices. Hb Decreased RBC – Microcytic,
Hypochromic in iron deficiency
Megaloblastic in vit B12 & FOLIC ACID deficiency
Red cell indices – MCV,MCH & MCHC Decreases
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BONE MARROW FINDINGS. Iron deficiency
anaemia Marrow Cellularity –
Erythroid Hyperplasia. Erythropoiesis –
Normoblastic Marrow Iron –
Deficient.
Megaloblastic anaemia.
Marrow cellularity – Megaloblastic Hyperplasia.
Marrow iron – by Prussian Blue staining increase in size & no of iron granules.
By:Mahi
THANK YOU
By:Mahi